Paramedics expected to be in high demand over next decade

Paramedic Brayden Hamilton Smith is seen here at a Toronto EMS station in Toronto, Ontario Thursday April 19, 2012.

Photograph by: Tim Fraser
, For Postmedia News

Brayden Hamilton-Smith found his calling while studying at Trent University in Peterborough when he volunteered for the medical team that provided first response for emergencies on campus.

That sparked his interest in the paramedic field and members of Peterborough Emergency Medical Services (EMS) steered him to community college. Hamilton-Smith enrolled in the Humber College Paramedic Diploma Program, which offered both hospital and field clinical components. He graduated in 2008.

"While there were positions available all over the province, many of us were competing for the positions available in the Greater Toronto Area," he says. "Bigger cities tend to offer better salaries and more opportunities for advancement."

He joined the Toronto EMS, Canada's largest at 850 paramedics, that same year. The service hired 47 paramedics in 2009, 54 in 2010 and 24 in 2011. It intends to hire approximately 24 paramedics this year.

Hamilton-Smith attributes the growth of the force to paramedics' efficiency as first responders. "In the past, there was the perception that paramedics were simply ambulance drivers offering blankets and oxygen," he says. "Today's paramedics offer the latest technology in combination with an expanded skill set. They can provide anything from intravenous medications to pacing the heart using electrical impulses, intubating someone with difficulty breathing or placing a needle into someone's lungs to relieve pressure at a car collision."

Hamilton-Smith is certified as a primary care paramedic, one authorized by a physician to perform a specific range of medical procedures. There are also advanced care and critical care paramedics, who are authorized to perform a wider range of patient services.

Typically, Hamilton-Smith spends a 12-hour shift working from a response vehicle in the vicinity of his home base. He and a partner take turns driving to calls. People are surprised, he says, to find that many dispatches aren't life-threatening emergencies and don't conclude with a trip to a hospital.

The dispatcher assigns priorities to calls, ranging from "alpha" at the lowest, to "echo" at the highest. Alpha calls include responding to a person with a recurring or chronic condition, or to someone who has fallen and needs assistance getting up.

"High priority calls are for someone who is choking or experiencing cardiac arrest, for example," says Hamilton-Smith.

"When we arrive, establishing communication is the most important thing. If you can't talk to them, it limits what you can do in a short time. You try to project a cool and calm exterior to the patient and quickly establish a sense of trust, and then show them that the trust they've given you is well founded. In some cases you're also dealing with family or bystanders."

It isn't necessarily severe injuries or serious situations that have the greatest impact on him.

"It's the little things," he says. "Like answering a pediatric call and seeing a child who looks like your own child or an older patient who resembles a relative. That's when it really hits home that you're here to make a positive difference in the outcome."

Chris Hood, president of the Paramedic Association of Canada, says advanced care paramedics are currently seeing the greatest opportunities for employment across the country.

"There are still always positions for primary care paramedics, especially in rural and remote areas, but the overall demand for primary care is going to increase over the next six or seven years as significant numbers of paramedics reach retirement age," he says.

Critical care paramedics will also see employment gains over the next three to five years as they're increasingly assigned to non-traditional roles, he says.

"We're seeing paramedics who once worked in ambulances now assigned to such locations as hospital emergency rooms," says Hood.

Hamilton-Smith recommends that applicants at any level make efforts to improve their employability.

"There are a lot of college programs out there and a lot of graduates," he says. "Further your education beyond what's required and try to distinguish yourself in a positive way, through volunteer efforts and hard work."

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